Preoperative Prediction of Ki-67 Status in Breast Cancer with Multiparametric MRI Using Transfer Learning

Acad Radiol. 2021 Feb;28(2):e44-e53. doi: 10.1016/j.acra.2020.02.006. Epub 2020 Apr 8.


Rationale and objectives: Ki-67 is one of the most important biomarkers of breast cancer traditionally measured invasively via immunohistochemistry. In this study, deep learning based radiomics models were established for preoperative prediction of Ki-67 status using multiparametric magnetic resonance imaging (mp-MRI).

Materials and methods: Total of 328 eligible patients were retrospectively reviewed [training dataset (n = 230) and a temporal validation dataset (n = 98)]. Deep learning imaging features were extracted from T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and contrast enhanced T1-weighted imaging (T1+C). Transfer learning techniques constructed four feature sets based on the individual three MR sequences and their combination (i.e., mp-MRI). Multilayer perceptron classifiers were trained for final prediction of Ki-67 status. Mann-Whitney U test compared the predictive performance of individual models.

Results: The area under curve (AUC) of models based on T2WI,T1+C,DWI and mp-MRI were 0.727, 0.873, 0.674, and 0.888 in the training dataset, respectively, and 0.706, 0.829, 0.643, and 0.875 in the validation dataset, respectively. The predictive performance of mp-MRI classification model in the AUC value was significantly better than that of the individual sequence model (all p< 0.01).

Conclusion: In clinical practice, a noninvasive approach to improve the performance of radiomics in preoperative prediction of Ki-67 status can be provided by extracting breast cancer specific structural and functional features from mp-MRI images obtained from conventional scanning sequences using the advanced deep learning methods. This could further personalize medicine and computer aided diagnosis.

Keywords: Breast cancer; Ki-67; Multiparametric MRI; Preoperative prediction; Transfer learning.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Neoplasms* / diagnostic imaging
  • Humans
  • Ki-67 Antigen
  • Machine Learning
  • Magnetic Resonance Imaging
  • Multiparametric Magnetic Resonance Imaging*
  • Retrospective Studies


  • Ki-67 Antigen